This study is concerned with the utility of a behavioral approach to amelioration of treatment-related distress in children with acute leukemia. Pediatric cancer patients undergo repeated, multiple medical procedures as part of the diagnostic and treatment regimen. A study of 101 pediatric cancer patients at our institution revealed acute pain and anxiety related to these procedures to be a primary problem. Symptoms were anticipatory (prior to procedures) and included nausea, vomiting, insomnia, nightmares, withdrawal and depression. We, therefore, have identified a need for non-intrusive techniques to reduce anxiety in this patient population. Evidence of the utility of hypnosis for anesthesia, analgesia, and relaxation exists in the scientific literature, along with data indicating minimal medical risk of this technique. Furthermore, children have superior hypnotic susceptibility when compared to adults. Despite successful reports of the use of hypnosis with cancer patients, controlled studies are lacking. In the proposed study, 40 children with acute lymphoblastic leukemia (ALL) will be randomly assigned to Treatment (hypnotic training) or Control (time-placebo) groups, and pretested for hypnotic susceptibility, and baseline distress. Response to subsequent bone marrow aspirations will be studied using measures developed and validated in our previous studies. Treatment effectiveness will be evaluated in terms of significant between-group differences. Methodological consideratons dictate homogeneity of sample and procedure. Thus, patients will be limited to those with ALL, and the procedure examined will be the bone marrow aspiration. The pediatrc cancer patient encounters a wide variety of painful procedures during treatment and results will, therefore, have broad ramifications for the use of behavioral approaches to pain and anxiety. An additional goal of the study will be to construct an instructional model for such treatment.